Neoliberal Plague: The Political Economy of HIV Transmission in Swaziland (original) (raw)
Related papers
Journal of Contemporary African Studies, 2019
Since the late twentieth century, HIV/AIDS-related global public health discourses in Eswatini (formerly Swaziland) have been driving cultural change there. Cultural change refers to local critical consciousness about the value of the royalist state's traditionalist policies and projects that get branded as a 'Swazi Culture'. Using feminist discourse analysis of health policy documents, supplemented by ethnographic insights, this article shows how global health discourses addressing the epidemic are critical of traditionalism predominately on grounds that it creates harms and transmission risk in gender-and sexual-based violence and inequalities for women. This criticism echoes a longer history of external interrogations of local sociocultural practices, today including kingship, as a gendered problem for health, a move that simultaneously interrogates state traditionalism but, in turn, solidifies the state's own cultural reifications. More broadly, this case shows how gender and sexuality reshape relationships between nation-states, health systems, and culture in postcolonial Africa.
Framing AIDS in Times of Global Crisis: 'Wasting' Africa yet Again? (with W. Nauta)
Globalizations, 2012
After some hope from the mid-2000s onwards, when unprecedented resources were mobilized to provide life-saving treatment to the millions dying from HIV/AIDS in the global South, donors are reneging on their promises, bowing to the imperative of austerity of a self-inflicted economic crisis. Drawing on Galtung’s typology of structural and cultural violence, this article examines how the rules and norms of global governance have shaped the context of policy responses to the pandemic in sub-Saharan Africa, and how these material struggles are intimately bound up with struggles over the frames through which the disease is portrayed and perceived by key policy actors and the public. First, we argue that the strikingly differential global distribution of the disease is, at least partially, attributable to the structural violence of Africa’s encounter with neoliberal capitalism. Second, we focus on two dominant frames— behavioral and philanthrocapitalist — and examine how they contributed to a depoliticization of the AIDS crisis, negating the counter-framing work of transnational AIDS activism. The latter, which has done so much to unmask our shared responsibility for the unequal distribution of vulnerability and death, is critical to countering the threat the economic crisis poses to the global HIV/AIDS response.
Discard Theory of Subjugation, Biopolitics, and Neoliberalism in HIV Policy
This paper aims to establish the role legal structures have played in supporting a cultural narrative of HIV-infected minorities as equivalent to garbage. The United States’ policy on HIV/AIDS emerges from an era of hysteria surrounding the disease, leaving the scientific legitimacy of the policy subject to question. HIV/AIDS regulation in the United States primarily serves to subjugate homosexuals, people who inject drugs, or people of color by rendering their actions impure and their bodies trash. These groups are unfairly targeted in these policies as part of a broader neoliberal political economy, as evidenced by the American laws that criminalize HIV transmission, ban blood donation from men who have sex with men (MSM), and bar the entry of HIV-positive travelers from entering the country. Discard theory provides an optic for viewing these American HIV policies as misguided. Additionally, the culture that generated these policies spurred a general resistance to harm reduction that further inhibits prevention and compassionate care. This political agenda sets the tone for international policies due to economic and epistemic hegemony of the United States in the developing world, particularly as this power affects global public health policy.
Depoliticising an Epidemic - International AIDS Control and the Politics of Health in Tanzania
PhD thesis in political science and development studies prepared at the Paris Graduate School of Social Sciences (EHESS) and the Albert-Ludwigs-Universität Freiburg (Germany), 2013
English abstract AIDS-control strategies in sub-Saharan Africa involve crucial national political compromises. Yet, they are frequently formulated in heteronomous settings dominated by Western donor agencies. Drawing on a case study of Tanzania, a country whose response to the epidemic is 97% donor-funded, this thesis develops a political economy of international AIDS control. It explores some of the specifically political aspects of the struggle against HIV/AIDS in Tanzania by analysing the formulation of national HIV-prevention and -treatment policies, and confronting these policies with a critical review of their biological and epidemiological foundations. The fieldwork combines a series of 92 in-depth interviews with key policymakers at the national level with the observation of AIDS-related decision processes in donor-government meetings. In this way, this thesis analyses the unequal political attention given to different causal stories of the spread of the virus, and their impact on the use of evidence in the formulation of HIV-prevention policies. Moreover, it describes how AIDS policymakers adopt non-decision strategies when faced with the intricate trade-offs imposed by the inescapable prioritization of HIV-prevention and -treatment interventions in a context of insufficient resources. Finally, developing upon an analysis of the controversy among players about the effects of international AIDS control on the overall coherence of national health policies, the thesis explores the contradictions of a vertical AIDS response in a context of dysfunctional health systems and poor general population health. On this basis, it examines the possibilities to elaborate an emancipatory critique. Résumé français Alors que les stratégies de lutte contre le sida en Afrique sub-saharienne mettent en jeu des compromis politiques nationaux fondamentaux, elles sont souvent formulées de manière hétéronome et dans un contexte marqué par la prédominance des bailleurs occidentaux. À partir de l’étude du cas tanzanien, cette thèse analyse différents aspects proprement politiques de la lutte contre le sida, à travers une double perspective : l’étude de l’élaboration des stratégies nationales de prévention et de traitement du VIH et l’analyse critique de leurs fondements biologiques et épidémiologiques. La recherche se fonde sur une enquête de terrain combinant des entretiens approfondis avec les principaux acteurs institutionnels au niveau national, et l’observation des processus décisionnels lors de réunions programmatiques. Cette thèse met ainsi en évidence l’attention politique inégale accordée aux différents récits causaux de la propagation du virus, et le rôle de ces histoires causales dans la formulation des politiques de prévention. Elle donne à voir les stratégies de non-décision ou de « contournement du politique » qu’adoptent les acteurs face aux arbitrages difficiles qu’impose la définition de priorités dans un contexte d’insuffisance des ressources. Enfin, à partir d’une analyse des controverses au sujet des effets de la réponse internationale au VIH/sida sur la cohérence des politiques de santé en Tanzanie, la thèse explore les contradictions d’une lutte verticale contre le sida dans un contexte marqué par un système de soins défaillant et une mauvaise santé générale de la population. Elle examine, sur cette base, les conditions d’élaboration d’une critique émancipatrice.
Politics in the Making of HIV/AIDS in South Africa
The HIV epidemic remains one of the most challenging of modern times, despite the enormous promise of anti-retroviral treatment. This timely book takes a critical look at HIV/AIDS in the context of South Africa, the country with the largest HIV epidemic in the world. Drawing on feminist science and technology studies and a close analysis of a range of textual sources, Politics in the Making of HIV/AIDS in South Africa tracks how the disease has been formed and transformed through political struggles. It illuminates the ways these struggles have also generated new selves for those living with HIV. In conducting this enquiry, the book addresses pressing questions about the politics of public health, the ethics of biological citizenship, and agency and the making of neoliberal subjects. It should appeal to scholars and students with interests in the sociology of health and medicine, the body in society, science and technology studies, and public health.